[Regina]

When a patient has capped rental equipment under one insurance, and switches to Medicare- I was once told by a Medicare CSR that we needed to start billing at the first month again. Does anyone know if this is still true?

[Kristin]

That is correct, Medicare will pay for 13th months rental on a capped rental item, regardless of whether or not another insurance has paid any rental months prior. Here is a question from a Medicare Q & A in regards to this issue:

Q7. I have a patient with a PAP that was rented for nine months from Blue Cross Blue Shield (BCBS). They are now Medicare eligible. Medicare would start over with a new capped rental even if nine months payment were received before, correct?
A7. Yes, since BCBS and Medicare are separate entitlements. We would follow Medicare rules and regulations and pay 13 months rental.fficeffice" />>>